The importance of chronic stress in the interruption of IVF treatments

Posted July 7, 2023

With the main goal of understanding the role of chronic stress in the interruption and discontinuation of in vitro fertilization (IVF), the INCT Hormona team of Universidade Federal de Minas Gerais (UFMG) conducted a systematic review to evaluate the characteristics, prevalence, and causes of what was perceived and reported as ‘stress’ by couples who discontinued IVF treatment. The article, Characteristics, prevalence and sources of stress in individuals who discontinue assisted reproductive technology treatments: a systematic review, is available at

According to Center coordinator Dr. Fernando Marcos dos Reis, 12 studies were included in the review, with 15,264 participants from eight countries. In all patients, ‘stress’ was assessed through generic questionnaires or medical records, and not by validated stress questionnaires or biomarkers. “We know that assisted reproductive technology treatments only have a 50% success rate per attempt, so to achieve pregnancy, most people need two or more cycles of treatment, and for that, you need to be calm, persistent, and resilient”, he commented.

Dr. Reis explains that, to date, there is no study that has objectively measured stress during assisted reproductive technology treatment, quantifying the symptoms and hormones involved, such as cortisol, for example. “There are only studies based on questionnaires, in which patients indicate the reasons for dropping out of treatment, but it is interesting to note that these studies reveal the presence of several stressors, that is, factors capable of triggering the stress response, such as family pressure, the high cost of treatments, and the fear of failure”, he explains. Dr. Reis says that more studies are needed to precisely understand the characteristics of infertility-related stress. “The next steps should be to quantify stress in people undergoing assisted reproductive technology treatment and assess the possible benefit of interventions capable of reducing stress, such as cognitive behavioral therapy”, he says. “If stress is a major cause of treatment dropout, perhaps some intervention aimed at reducing stress will help people adapt better and move on.”